Here is a prediction we have made enough times to call a pattern: when a medical centre is struggling, the practice manager was hired for the wrong job. Not the wrong person — the wrong job. They were told to answer the phones, watch the staff, order the stock and keep the doctors happy. Nobody told them they were running a business with clinical risk, a payroll, a Medicare relationship and forty people who depend on it.
The job most centres think they are hiring for
Reception supervisor. Roster writer. The person who orders gloves and chases the cleaner. Someone senior enough to handle a complaint and organised enough to find the policy binder when the assessor comes. That job exists, and it is a senior receptionist or team leader. It is not practice management.
The job the practice actually needs
A practice manager in a general practice is a multi-skilled business leader whose role touches every part of the clinic. In our experience the role has six parts, and a manager who is missing any of them leaves a hole the owner ends up filling at eleven at night.
1. Doctor support
Doctors stay where the practice works. The manager makes sure each doctor has a full and sensible book, a room and equipment that are ready, templates and referrals set up, provider numbers and credentialing current, a nurse doing the care plans and health assessments, and billing that pays them correctly for the work they do. The manager also has the awkward conversations — sessions, contracts, behaviour — so the owner doesn’t have to.
2. Nursing and clinical support
The manager doesn’t practise nursing, but they own the systems around it: infection control and cleaning schedules, cold chain, sterilisation records, recalls and reminders, care plan and health assessment workflows, emergency equipment checks, and the nurse’s time — which is the most under-used revenue and quality asset in most practices.
3. Reception and patient experience
Triage protocols, phone conversion, booking rules, privacy, results handling, difficult patients, the waiting room. The manager trains reception, writes the checklists, and watches the numbers — abandoned calls, no-shows, wait times — because patient experience is operational, not a poster.
4. The business
Billings by doctor and item, unbilled work, private fee setting and bulk-billing mix, incentive programs, doctor pays and service fees, staffing cost against demand, supplier and pathology arrangements, and a monthly report to the owner that says what happened and what to do. If the manager cannot read a Cubiko dashboard and a profit-and-loss statement, the practice is flying blind.
5. Compliance and quality
Owning the RACGP Standards year-round — not the month before the survey. Policies that match the practice, training records that exist, logs that are kept continuously, quality improvement that runs every year, credentialing files that are complete. Under the 6th edition, this becomes the whole job, not a project.
6. People
Hiring, onboarding, rosters, performance, immunisation records, contracts, the culture in the tea room. Turnover in medical reception is usually a management problem before it is a pay problem.
The test we use: could the manager run the practice for a month with the owner overseas and no phone calls? If the honest answer is no, the practice has a supervisor, not a manager — and the owner is the manager.
Why it goes wrong
Three reasons, in the order we see them. The role was scoped as the basics and paid as the basics, so a capable person was never expected to do more. The manager was promoted from reception — often a great choice — and then learned compliance, HR, billing and doctor management in real time with nobody to ask. And the owner is a doctor with a full list who cannot supervise a business role they have never done themselves.
How to fix it
- Re-scope the role around the six parts above, in writing, and pay for that role.
- Train inside the practice. Classroom courses help; a mentor who has run practices, sitting beside the manager for weeks, changes behaviour. This is what our practice manager training is.
- Give them the numbers. Cubiko or equivalent, a one-page monthly review, and permission to act on it.
- Give them someone to call. Most managers have nobody senior. An operations retainer or an experienced peer fills that gap for a fraction of a second manager.
- Measure the role on retention of doctors and staff, billing accuracy, compliance continuity and patient growth — not on whether the phones were answered.
The practices that run well have a manager who understands their role in doctor support, nursing and reception support, patient care and the business — all of it. That is the job. Hire for it, train for it, and pay for it.
Quick answers
What qualifications does a practice manager need?
There is no mandatory qualification for general practice management in Australia. What matters is capability across the whole role — people, doctors, clinical support, money, compliance and systems — and the willingness to keep learning. Formal study helps; so does mentoring from someone who has run practices. We train and mentor managers inside their own practice because that is where the job is learned.
How many staff should a practice manager oversee?
It depends on doctor numbers, sites and services more than headcount. A single-site practice with four to eight GPs typically runs with one manager, a senior receptionist or team leader, and a nurse lead. Beyond that, or across sites, an operations layer is needed so the manager is not the only person who can make a decision.
What should a practice manager be paid?
We don’t publish figures because the range is wide and the role varies. The useful test is what a good manager is worth: a manager who watches billing, keeps doctors, keeps staff and keeps the practice compliant pays for themselves many times over. Underpaying for a “basics” role and then expecting business leadership is the most common mistake we see.
Fifteen years in medical practice operations. MBA, Melbourne Business School. Two medical centres built and sold; ten-plus centres overseen today. About Jamal →